President Seeks To Extend Health-Care Coverage

The spending plan President Clinton submitted to Congress this month
promises to shrink Medicaid costs while extending the blanket of health
insurance to cover millions of the nation's poorest children.

Mr. Clinton's proposed $376 billion budget for the Department of
Health and Human Services calls for more than $8 billion in programs
that would expand the Head Start rolls, offer health insurance to poor
children, pay for efforts to reduce teenage pregnancy, and take a stab
at thwarting advertising by tobacco companies when they aim to entice
young people.

The budget request for the fiscal year that will begin Oct. 1 calls
for a 7 percent increase in the agency's overall budget compared with
current spending.

President Clinton's budget proposes to increase spending for the
Head Start preschool program to $4 billion--a 10 percent hike over
current spending.

The increased federal funds would allow Head Start to serve 36,000
more children and their families, according to HHS estimates.

In an effort to curb teenage birthrates, the administration is also
asking for $14 million for the department's ongoing adolescent
family-life program, which finances abstinence-based sex education in
schools. Fighting adolescent substance abuse is also a priority in the
fiscal 1998 budget.

The HHS budget includes an unprecedented $85 million request to wage
a mass media campaign to thwart teenage drug use, pay for research on
drug education, and finance state-run anti-drug programs.

At a press conference announcing the spending proposals this month,
HHS Secretary Donna E. Shalala hailed the new budget as "a force for
good."

"This budget makes an unprecedented commitment to lifting the lives
of our children and adolescents by addressing the issues that keep too
many parents up at night," Ms. Shalala said.

Extending Health Care

The cornerstone of the president's health initiatives is a $3
billion-a-year plan to extend health coverage to 5 million uninsured
children by 2000. The plan would cover roughly half the children who
currently lack health coverage.

The plan includes $1.7 billion to help low-income parents who are
out of work pay for up to six months of health coverage.

HHS officials estimate this would help insure 700,000 children.

The children's health initiative would also earmark $750 million in
annual grants to states to reach children who fall through the cracks
because their families earn too much to be eligible for Medicaid, but
not enough to afford private insurance.

No Great Comfort

For those eligible for Medicaid, the Clinton administration hopes
that the new money would help supplement states' efforts to reach more
eligible children and adolescents.

But some children's advocates said last week that the
administration's plan is no great comfort to needy families.

At the same time that Mr. Clinton is proposing more health insurance
for children, his budget calls for slicing overall spending for the
Medicaid program by $9 billion over five years, budget documents
show.

Debbie Weinstein, the director of the family-income division of the
Children's Defense Fund, a Washington advocacy group, argued that
scaling back Medicaid spending would undercut the president's goal of
promoting child health.

"While one hand gives something like health insurance, the other
hand is taking it away," she said.

Some Democratic leaders in Congress praised President Clinton last
week for making children's health a legislative priority, but said that
such incremental approaches won't go far enough to serve poor
children.

Sens. Edward M. Kennedy and John Kerry, both Massachusetts
Democrats, have introduced a bill to provide federal vouchers to poor
and moderate-income families to buy insurance.

The bill would provide coverage to the country's 10 million
uninsured children. Funding would be raised through a proposed 75-cent
tax on tobacco, according to a spokesman for Sen. Kennedy.

It is unclear, however, how any new government programs will be
received as the Republican-controlled Congress resumes efforts to
balance the federal budget by 2002.